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Tree-removal treatments have been broadly applied across piñon-juniper ecosystems of the western United States to reduce tree cover, stimulate understory plant production, and promote habitat for shrub- and grassland-obligate wildlife species. Mastication treatments have become an increasingly common approach, yet the efficacy of these treatments can vary on the basis of a variety of factors, including soil characteristics, woodland structure, and grazing pressures. Here, we assessed vegetation responses to mastication treatments across three dominant soil types in two-needle piñon (Pinus edulis Engelm. [Pinaceae])−one-seed juniper (Juniperus monosperma [Engelm.] Sarg.) woodlands in southeast Colorado, United States, a region characterized by monsoonal precipitation, limited presence of introduced plant species, and relatively high grazing intensity by cattle and wildlife. We found that mastication treatments were effective at increasing herbaceous plant cover and species diversity (by 1.2 × and 1.5 ×) and at reducing the amount of exposed soil (60% reduction) 3 yr following treatment. This was mainly due to increases in native perennial grasses. Further, there were limited (and insignificant) increases in cover of annual plants and low abundance of introduced species in treated plots. Understory plant responses to treatment were similar across soils with a range of available water capacities. The increase in understory plant cover and richness paired with the low abundance of introduced species suggests that mastication treatments increase forage production for cattle and wild ungulates. In addition, the lack of soil type differences in treatment response suggests that mastication treatment placement does not need to prioritize soil type and can instead focus on other key areas of importance, such as wildlife habitat connectivity, historic woodland structure, and treatment feasibility.

Introduction:Asymmetric warfare and the reaction to its threats have implications in the way far-forward medical assistance is provided in such settings. Investments in far-forward emergency resuscitation and stabilization can contribute to saving lives and increase the resilience of health systems. Thus, it is proposed to extend the use of the Haddon Matrix to determine a set of strategies to better understand and prioritize activities to prepare for and set-up frontline care in the form of Trauma Stabilization Points (TSPs).Methods:An expert consensus methodology was used to achieve the research aim. A small subject matter experts’ group was convened to create and validate the content of the Haddon Matrix.Results:The result of the expert group consultations presented an overview of TSP Preparedness and Operational Readiness activities within a Haddon Matrix framework. Main strategies to be adopted within the cycle from pre- to post-event had been identified and presented considering the identified opportunities in the context of the possibility of implementation. Of particular importance was the revision of a curriculum that fits the civilian medical system and facilitates its adaptation to the context and available resources.Conclusion:The new framework to enhance frontline care preparedness and response using the Haddon Matrix facilitated the identification of a set of strategies to support frontline health care workers in a more efficient manner. Since the existing approach and tools are insufficient for modern warfare, additional research is needed.

12 páginas.- 4 figuras.- referencias.- Additional supporting information can be found online in the Supporting Information section at the end of this article.- Full Access in https://onlinelibrary.wiley.com/doi/full/10.1111/geb.13652, Aim Our understanding of the mechanisms that maintain forest diversity under changing climate can benefit from knowledge about traits that are closely linked to fitness. We tested whether the link between traits and seed number and seed size is consistent with two hypotheses, termed the leaf economics spectrum and the plant size syndrome, or whether reproduction represents an independent dimension related to a seed size–seed number trade-off. Location Most of the data come from Europe, North and Central America and East Asia. A minority of the data come from South America, Africa and Australia. Time period 1960–2022. Major taxa studied Trees. Methods We gathered 12 million observations of the number of seeds produced in 784 tree species. We estimated the number of seeds produced by individual trees and scaled it up to the species level. Next, we used principal components analysis and generalized joint attribute modelling (GJAM) to map seed number and size on the tree traits spectrum. Results Incorporating seed size and number into trait analysis while controlling for environment and phylogeny with GJAM exposes relationships in trees that might otherwise remain hidden. Production of the large total biomass of seeds [product of seed number and seed size; hereafter, species seed productivity (SSP)] is associated with high leaf area, low foliar nitrogen, low specific leaf area (SLA) and dense wood. Production of high seed numbers is associated with small seeds produced by nutrient-demanding species with softwood, small leaves and high SLA. Trait covariation is consistent with opposing strategies: one fast-growing, early successional, with high dispersal, and the other slow-growing, stress-tolerant, that recruit in shaded conditions. Main conclusions Earth system models currently assume that reproductive allocation is indifferent among plant functional types. Easily measurable seed size is a strong predictor of the seed number and species seed productivity. The connection of SSP with the functional traits can form the first basis of improved fecundity prediction across global forests., The project has been funded by grants to J.S.C. from the National Science Foundation, most re-cently DEB-1754443, and by the Belmont Forum (1854976), NASA (AIST16-0052 and AIST18-0063) and the Programme d'Investissement d'Avenir under project FORBIC (18-MPGA-0004; Make Our Planet Great Again). Jerry Franklin's data remain acces-sible through NSF LTER DEB-1440409. Data from Hubbard Brook (New Hampshire) were funded through NSF-LTER. Puerto Rico data were funded by NSF grants, most recently DEB 0963447 and LTREB 11222325. Data from the Andes Biodiversity and Ecosystem Research Group were funded by the Gordon and Betty Moore Foundation and NSF 727 LTREB 1754647. M.B. was supported by grant no. 2019/35/D/NZ8/00050 from the (Polish) National Science Centre and by Polish National Agency for Academic Exchange Bekker programme PPN/BEK/2020/1/00009/U/00001. Research by the USDA Forest Service and the USGS was funded by these agencies. Any use of trade, firm or product names does not imply endorsement by the US Government. Any use of trade, firm, or product names is for descriptive purposes only and does not imply en -dorsement by the U.S. Government

Background The benefit of continuing thiopurine in ulcerative colitis (UC) responders to vedolizumab (VED) is unclear. We aimed to determine the effect of thiopurine withdrawal in VED-treated UC patients on combination therapy. Methods This prospective multi-centre, single-blind, randomised controlled trial recruited UC patients on VED 300mg IV every 8 weeks and a thiopurine for ≥6 months. Patients in steroid-free clinical remission (partial Mayo score[pMS]≤2, no subscore>1) and endoscopic remission/improvement (Mayo endoscopic subscore[MES]≤1) were randomised 2:1 to withdraw or continue thiopurine. Primary outcome was comparing week 48 VED trough levels. Secondary outcomes were disease relapse (pMS≥3 and faecal calprotectin>150μg/g or increase in MES≥1 from baseline), centrally-read endoscopic remission (MES=0), histologic remission (Nancy index=0), histo-endoscopic remission, faecal calprotectin (remission Results Sixty-two consecutive patients (58% males, median follow-up 23.0 months) were randomised to withdraw (n=42) or continue (n=20) thiopurine. Randomisation was balanced. Complete data was available for 58 patients. There was a non-significant trend toward increased disease relapse in the withdrawal group (P=0.12, Fig. 1). In the withdrawal group, baseline histologic activity significantly increased disease relapse (HR:5.8, 95%CI:1.6-20.8, P=0.007, Fig. 2). There was a trend towards higher relapse rates in the withdrawal versus continue groups for bio-exposed patients (50.0% [6/12] vs 0.0% [0/4], P=0.07) but not bio-naïve patients (20.0% [6/30] vs 12.5% [2/16], P=0.52). At week 48, the continue group had significantly higher histologic remission (OR:4.6, 95%CI:1.1-18.9, P=0.03) and histo-endoscopic remission rates (OR:4.6, 95%CI:1.3-16.1, P=0.01, Fig. 3) versus the withdrawal group, but similar endoscopic remission rates (P=0.09, Fig. 3). Faecal calprotectin remission was significantly higher in the continue (94% [16/17]) versus withdrawal group (70% [28/40], P=0.047) with mean calprotectin 44.5μg/g±SD56.2 vs 209.6μg/g±SD344.2 (P=0.003) respectively. On multivariate analysis, histologic activity at baseline (HR:5.3, 95%CI:1.1-26.2,P=0.04) predicted disease relapse. Week 48 median VED levels were 15.9µg/mL (IQR:10.1-22.7) in the withdrawal group versus 14.7µg/mL (IQR:12.1-18.7) in the continue group (P=0.43). No patients had anti-VED antibodies. There was no significant difference in adverse events between groups. Conclusion Although thiopurine withdrawal did not affect VED trough level, it increased calprotectin, histologic and histo-endoscopic activity in UC. In patients with histological activity despite deep remission, thiopurine withdrawal significantly increased the risk of disease relapse.

Significance Forests are experiencing growing risks of drought-induced mortality in a warming world. Yet, ecosystem dynamics following drought mortality remain unknown, representing a major limitation to our understanding of the ecological consequences of climate change. We provide an emerging picture of postdrought ecological trajectories based on field indicators of forest dynamics. Replacement patterns following mortality indicate limited short-term persistence of predrought dominant tree species, highlighting the potential for major ecosystem reorganization in the coming decades. The great variability of the observed dynamics within and among species reinforces the primary influence of drought characteristics and ecosystem legacies, modulated by land use, management, and past disturbances, on ongoing drought-related species turnover and their potential implications for future forest biodiversity and ecosystem services., Forest vulnerability to drought is expected to increase under anthropogenic climate change, and drought-induced mortality and community dynamics following drought have major ecological and societal impacts. Here, we show that tree mortality concomitant with drought has led to short-term (mean 5 y, range 1 to 23 y after mortality) vegetation-type conversion in multiple biomes across the world (131 sites). Self-replacement of the dominant tree species was only prevalent in 21% of the examined cases and forests and woodlands shifted to nonwoody vegetation in 10% of them. The ultimate temporal persistence of such changes remains unknown but, given the key role of biological legacies in long-term ecological succession, this emerging picture of postdrought ecological trajectories highlights the potential for major ecosystem reorganization in the coming decades. Community changes were less pronounced under wetter postmortality conditions. Replacement was also influenced by management intensity, and postdrought shrub dominance was higher when pathogens acted as codrivers of tree mortality. Early change in community composition indicates that forests dominated by mesic species generally shifted toward more xeric communities, with replacing tree and shrub species exhibiting drier bioclimatic optima and distribution ranges. However, shifts toward more mesic communities also occurred and multiple pathways of forest replacement were observed for some species. Drought characteristics, species-specific environmental preferences, plant traits, and ecosystem legacies govern postdrought species turnover and subsequent ecological trajectories, with potential far-reaching implications for forest biodiversity and ecosystem services.

Ongoing changes in fire regimes have the potential to drive widespread shifts in Earth's vegetation. Plant traits and vital rates provide insight into vulnerability to fire‐driven vegetation shifts because they can be indicators of the ability of individuals to survive fire (resistance) and populations to persist (resilience) following fire. In 15 study sites spanning climatic gradients in the southern Rocky Mountains, USA, we quantified variation in key traits and vital rates of two co‐occurring, widely distributed conifers (Pinus ponderosa Douglas ex. P. Lawson & C. Lawson and Pseudotsuga menziesii (Mirb.) Franco). We used mixed‐effects models to explain inter‐ and intraspecific variation in tree growth, survival, bark thickness and seed cone production, as a function of species, tree life stage (i.e. diameter, height and age), average climate, local competition and site conditions. Pinus ponderosa was predicted to survive low‐severity fire at a 23% earlier age than P. menziesii. Pinus ponderosa had thicker bark and more rapid juvenile height growth, traits conferring greater fire resistance. In contrast, P. menziesii was predicted to produce seed cones at a 28% earlier age than P. ponderosa. For both species, larger individuals were more likely to survive fire and to produce cones. For P. ponderosa, cone production increased where average actual evapotranspiration (AET) was higher and local competition was lower. More frequent cone production on productive sites with higher AET is an important and underappreciated mechanism that may help to explain greater resilience to fire in these areas. Synthesis. Our analyses indicated that many plant traits and vital rates related to fire differed between Pinus ponderosa and Pseudotsuga menziesii, with trade‐offs between investment in traits that promote individual defence to fire and those that promote recolonization of disturbed sites. Future changes in fire regimes will act as a filter throughout North American forests, with our findings helping to infer which individuals and populations of two iconic species are most vulnerable to future change and offering a framework for future inquiry in other forests facing an uncertain future.

Climate change is causing significant shifts in tree species distributions to higher elevations and latitudes. Seed germination and seedling establishment are particularly important steps in tree range expansion under warmer conditions, yet seedling establishment is influenced by a range of factors beyond temperature, including herbivory, microenvironment, and the timing and amount of precipitation. We conducted an experiment to assess how augmented precipitation regimes, wildlife herbivory, and microclimate influence germination and first-season survival of Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco) near the upper elevational limit of its range in the southern Rocky Mountains. Germination was strongly influenced by moisture, with over three times higher germination in watered treatments. Seedling survival was similar across watered treatments but was negatively associated with microenvironments with higher maximum temperatures. These results indicate that soil moisture effects on germination and the negative impact of hot growing-season temperatures on seedling survival limit initial seedling establishment in Douglas-fir, even at the cooler and wetter end of its range, suggesting that the planting of this species will be most successful in cooler and wetter microsites. Taken together, this study suggests that continued warming and projected increases in droughts may strongly limit Douglas-fir regeneration and thus its ability to shift upwards with climate change.

Masting, or the synchronous and irregular production of seed crops, is controlled by environmental conditions and resource budgets. Increasing temperatures and shifting precipitation regimes may alter the frequency and magnitude of masting, especially in species that experience chronic resource stress. Yet the effects of a changing climate on seed production are unlikely to be uniform across populations, particularly those that span broad abiotic gradients. In this study, we assessed the spatiotemporal patterns of masting across the latitudinal distribution of a widely distributed dryland conifer species, pinon pine Pinus edulis. We quantified seed cone production from 2004 to 2017 using cone abscission scars in 187 trees from 28 sites along an 1100 km latitudinal gradient to investigate the spatiotemporal drivers of seed cone production and synchrony across populations. Populations from chronically hot and dry areas (greater climatic water deficits and less monsoonal precipitation) tended to have greater interannual variability in seed cone production and smaller crop sizes. Mast years generally followed years with low vapor pressure deficits and high precipitation during key periods of the reproductive process, but the strength of these relationships varied across the region. Populations that received greater monsoonal precipitation were less sensitive to late summer vapor pressure deficits during seed cone initiation yet more sensitive to spring vapor pressure deficits during pollination. Spatially correlated patterns of vapor pressure deficit better predicted synchrony in seed cone production than geographic distance, and these patterns were conserved at distances up to 500 km. These results demonstrate that aridity drives spatiotemporal variability in seed cone production. As a result, projected increases in aridity are likely to decrease the frequency and magnitude of masting in these dry forests and woodlands. Declines in seed production may compound climatic limitations to recruitment and impede tree regeneration, with cascading effects for numerous wildlife species.

Objectives COVID-19 temporary emergency ‘field’ hospitals have been established in the UK to support the surge capacity of the National Health Service while protecting the community from onward infection. We described the population of one such hospital and investigated the impact of frailty on clinical outcomes. Design Cohort study. Setting NHS Nightingale Hospital North West, April–June 2020. Participants All in-patients with COVID-19. Main Outcome Measures Mortality and duration of admission. Methods We analysed factors associated with mortality using logistic regression and admission duration using Cox's regression, and described trends in frailty prevalence over time using linear regression. Results A total of 104 COVID-19 patients were admitted, 74% with moderate-to-severe frailty (clinical frailty score, CFS > 5). A total of 84 were discharged, 14 transferred to other hospitals, and six died on site. High C-reactive protein (CRP) > 50 mg/dL predicted 30-day mortality (adjusted odds ratio 11.9, 95%CI 3.2–51.5, p 5 had a 10-day median admission, versus 7-day for CFS ≤ 5 and half the likelihood of discharge on a given day (adjusted hazard ratio 0.51, 95%CI 0.29–0.92, p = 0.024). CRP > 50 mg/dL and hospital-associated COVID-19 also predicted admission duration. As more frail patients had a lower rate of discharge, prevalence of CFS > 5 increased from 64% initially to 90% in the final week (non-zero slope p

12 Pág., The relationships that control seed production in trees are fundamental to understanding the evolution of forest species and their capacity to recover from increasing losses to drought, fire, and harvest. A synthesis of fecundity data from 714 species worldwide allowed us to examine hypotheses that are central to quantifying reproduction, a foundation for assessing fitness in forest trees. Four major findings emerged. First, seed production is not constrained by a strict trade-off between seed size and numbers. Instead, seed numbers vary over ten orders of magnitude, with species that invest in large seeds producing more seeds than expected from the 1:1 trade-off. Second, gymnosperms have lower seed production than angiosperms, potentially due to their extra investments in protective woody cones. Third, nutrient-demanding species, indicated by high foliar phosphorus concentrations, have low seed production. Finally, sensitivity of individual species to soil fertility varies widely, limiting the response of community seed production to fertility gradients. In combination, these findings can inform models of forest response that need to incorporate reproductive potential., The project has been funded continuously since 1992 by National Science Foundation grants to J.S.C, most recently DEB-1754443, and by the Belmont Forum (1854976), NASA (AIST16-0052, AIST18-0063), and the Programme d’Investissement d’Avenir under project FORBIC (18-MPGA-0004)(Make Our Planet Great Again). Puerto Rico data were funded by NSF grants to M.U., most recently, DEB 0963447 and LTREB 11222325. Data from the Andes Biodiversity and Ecosystem Research Group were funded by the Gordon and Betty Moore Foundation and NSF LTREB 1754647 to M.S. Additional funding to M.Z. came from the W.Szafer Institute of Botany of the Polish Academy of Sciences and the Polish National Science Foundation (2019/33/B/NZ8/0134). M.B. was supported by the Polish National Science Centre grant no. 2019/35/D/NZ8/00050, and Polish National Agency for Academic Exchange Bekker programme PPN/BEK/2020/1/00009/U/00001. J.M.L. was supported by NSF grant DEB 1745496. Jerry Franklin’s data remain accessible through NSF LTER DEB-1440409. USDA Forest Service and USGS research was funded by those agencies.

12 páginas.- 5 figuras.- 67 referencias.- Additional supporting information may be found in the online version of the article at the publisher’s website .- The peer review history for this article is available at https://publons.com/publon/10.1111/ele.14012 .- All data and code supporting our results are archived on the Zenodo Repository at the following link: https://doi.org/10.5281/zenodo.6381799, Lack of tree fecundity data across climatic gradients precludes the analysis of how seed supply contributes to global variation in forest regeneration and biotic interactions responsible for biodiversity. A global synthesis of raw seedproduction data shows a 250-fold increase in seed abundance from cold-dry to warm-wet climates, driven primarily by a 100-fold increase in seed production for a given tree size. The modest (threefold) increase in forest productivity across the same climate gradient cannot explain the magnitudes of these trends. The increase in seeds per tree can arise from adaptive evolution driven by intense species interactions or from the direct effects of a warm, moist climate on tree fecundity. Either way, the massive differences in seed supply ramify through food webs potentially explaining a disproportionate role for species interactions in the wet tropics., The project has been funded by grants to JSC from the National Science Foundation, most recently DEB-1754443, and by the Belmont Forum (1854976), NASA (AIST16-0052, AIST18-0063) and the Programme d’Investissement d’Avenir under project FORBIC (18-MPGA-0004) (Make Our Planet Great Again). Jerry Franklin’s data remain accessible through NSF LTER DEB-1440409. Puerto Rico data were funded by NSF grants, most recently, DEB 0963447 and LTREB 11222325. Data from the Andes Biodiversity and Ecosystem Research Group were funded by the Gordon and Betty Moore Foundation and NSF LTREB 1754647. MB was supported by grant no. 2019/35/D/NZ8/00050 from the (Polish) National Science Centre, and Polish National Agency for Academic Exchange Bekker programme PPN/BEK/2020/1/00009/U/00001. Research by the USDA Forest Service and the USGS was funded by these agencies. Any use of trade, firm or product names does not imply endorsement by the US Government.

Introduction: More than one million breast augmentation procedures using silicone breast implants (SBI) have been performed worldwide. Adverse events of SBI include local complications such as pain, swelling, redness, infections, capsular contracture, implant rupture, and gel-bleed. Furthermore, patients experience systemic symptoms such as chronic fatigue, arthralgias, myalgias, pyrexia, sicca, and cognitive dysfunction. These symptoms received different names such as autoimmune/autoinflammatory syndrome induced by adjuvants (ASIA) due to silicone incompatibility syndrome and breast implant illness (BII). Because of chronic immune activation, BII/ASIA, allergies, autoimmune diseases, immune deficiencies, and finally lymphomas may develop in SBI patients.Areas covered: Causality for SBI-related BII/ASIA is reviewed. To address the role of silicone implants in promoting causality, we utilized the Bradford Hill criteria, with results highlighted in this article.Expert opinion: We conclude that there is a causal association between SBIs and BII/ASIA. Using data derived from patients with BII/ASIA and from other medically implanted devices, there appears to be clear pathogenic relationship between SBI and BII/ASIA. Breast implants cause characteristic systemic reactions in certain women, leading to symptoms of sufficient severity to warrant device removal. The morbidity suffered is variable. SBI removal resolves the symptoms in most women, and removal is the most effective treatment.

Indirect climate effects on tree fecundity that come through variation in size and growth (climate-condition interactions) are not currently part of models used to predict future forests. Trends in species abundances predicted from meta-analyses and species distribution models will be misleading if they depend on the conditions of individuals. Here we find from a synthesis of tree species in North America that climate-condition interactions dominate responses through two pathways, i) effects of growth that depend on climate, and ii) effects of climate that depend on tree size. Because tree fecundity first increases and then declines with size, climate change that stimulates growth promotes a shift of small trees to more fecund sizes, but the opposite can be true for large sizes. Change the depresses growth also affects fecundity. We find a biogeographic divide, with these interactions reducing fecundity in the West and increasing it in the East. Continental-scale responses of these forests are thus driven largely by indirect effects, recommending management for climate change that considers multiple demographic rates., Nature Communications, 12, ISSN:2041-1723

We aimed to disentangle the patterns of synchronous and variable cone production (i.e. masting) and its relationship to climate in two conifer species native to dry forests of western North America. We used cone abscission scars to reconstruct ca 15 years of recent cone production in Pinus edulis and Pinus ponderosa , and used redundancy analysis to relate time series of annual cone production to climate indices describing the North American monsoon and the El Niño Southern Oscillation (ENSO). We show that the sensitivity to climate and resulting synchrony in cone production varies substantially between species. Cone production among populations of P. edulis was much more spatially synchronous and more closely related to large-scale modes of climate variability than among populations of P. ponderosa . Large-scale synchrony in P. edulis cone production was associated with the North American monsoon and we identified a dipole pattern of regional cone production associated with ENSO phase. In P. ponderosa , these climate indices were not strongly associated with cone production, resulting in asynchronous masting patterns among populations. This study helps frame our understanding of mast seeding as a life-history strategy and has implications for our ability to forecast mast years in these species. This article is part of the theme issue ‘The ecology and evolution of synchronized seed production in plants’.

Our overall objective is to synthesize mast-seeding data on North American Pinaceae to detect characteristic features of reproduction (i.e. development cycle length, serotiny, dispersal agents), and test for patterns in temporal variation based on weather variables. We use a large dataset ( n = 286 time series; mean length = 18.9 years) on crop sizes in four conifer genera ( Abies , Picea , Pinus , Tsuga ) collected between 1960 and 2014. Temporal variability in mast seeding (CVp) for 2 year genera ( Abies , Picea , Tsuga ) was higher than for Pinus (3 year), and serotinous species had lower CVp than non-serotinous species; there were no relationships of CVp with elevation or latitude. There was no difference in family-wide CVp across four tree regions of North America. Across all genera, July temperature differences between bud initiation and the prior year (Δ T ) was more strongly associated with reproduction than absolute temperature. Both CVp and Δ T remained steady over time, while absolute temperature increased by 0.09°C per decade. Our use of the Δ T model included a modification for Pinus , which initiates cone primordia 2 years before seedfall, as opposed to 1 year. These findings have implications for how mast-seeding patterns may change with future increases in temperature, and the adaptive benefits of mast seeding. This article is part of the theme issue ‘The ecology and evolution of synchronized seed production in plants’.

International audience; Despite its importance for forest regeneration, food webs, and human economies, changes in tree fecundity with tree size and age remain largely unknown. The allometric increase with tree diameter assumed in ecological models would substantially overestimate seed contributions from large trees if fecundity eventually declines with size. Current estimates are dominated by overrepresentation of small trees in regression models. We combined global fecundity data, including a substantial representation of large trees. We compared size–fecundity relationships against traditional allometric scaling with diameter and two models based on crown architecture. All allometric models fail to describe the declining rate of increase in fecundity with diameter found for 80% of 597 species in our analysis. The strong evidence of declining fecundity, beyond what can be explained by crown architectural change, is consistent with physiological decline. A downward revision of projected fecundity of large trees can improve the next generation of forest dynamic models.

Objective:The effectiveness of Emergency Medical Teams (EMTs) is strongly related to their time of arrival, and usually only few teams arrive within 24-48 h postdisaster. The decision to deploy and the scale of deployment rely heavily on context and nature of the event and consequently a rapid assessment of needs/gaps is critical to an appropriate and customized response.Methods:In this study, we describe a desk-based study that provides: (1) knowledge about the medical needs that can be anticipated according to the phases of the disaster that is not rich in literature; and (2) a decision support framework for the deployment of EMTs to earthquakes that combines the results of a literature research and a Delphi study involving the opinion of 12 experts in the field.Results:The resulting framework is a tool that will help better mapping the configuration to the needs on the ground at the time the team becomes operational in the field and will assist those responsible for deploying and/or accepting EMTs in making informed decisions on deployment after an earthquake.Conclusions:With additional research the framework approach may be adapted to other types of international relief such as to deploy a Search And Rescue (SAR) team.

Prairie streams are dynamic systems in which habitat patches are sporadically created and lost during extreme hydrological events. The persistence of fish species depends on life‐history traits that facilitate their widespread dispersal to recolonize habitats after stochastic extirpation. Artificial barriers are thought to reduce recolonization opportunities and to ultimately displace populations downstream, but the ecological consequences of lost diversity above the barriers are largely unknown. The susceptibility of four prairie fishes to fragmentation and the consequent risk to stream ecosystem processes are described. The selected species exhibit wide tolerances to environmental stressors, represent unique functional feeding guilds, and have different habitat affinities. The ability of each species to access (jumping ability) and successfully traverse (swimming endurance) simulated instream barriers was quantified in the laboratory. Experimental stream complexes were used to isolate the effects of these species on ecosystem structure and function. These replicated single‐species experiments were compared with ‘no fish’ controls to identify the ecological role of each. Small vertical barriers blocked most passage, and with open access all species were unable to traverse relatively short distances against modest water velocities. Stream fragmentation will alter headwater fish assemblage structure and promote the most mobile species. Each species had slightly different effects on the stream ecosystem structure resulting from their different habitat preferences and diets. Without colonization opportunities from neighbouring populations, disturbance events will alter headwater fish assemblages and may degrade the ecosystem structure above barriers. Fragmented riverscapes interact with harsh disturbance regimes to form an ecological ratchet. Systematic species loss above barriers outweighs the opportunity for improvement, suggesting that ecosystem structure may be moving downstream.

Climate change is driving rapid and dramatic changes in forests across the globe, as highlighted by recent widespread drought-induced tree mortality events. Long-term changes in these forest ecosystems will be dependent upon the ability of trees to regenerate following overstory mortality under a warmer and drier climate. The goal of this study was to assess how tree mortality, and environmental gradients imposed by topographic and edaphic conditions, interact to influence tree regeneration in subalpine spruce-fir forests in a region experiencing rapid climate warming. We evaluated regeneration of two widely distributed subalpine forest species of the Rocky Mountains, subalpine fir (Abies lasiocarpa) and Engelmann spruce (Picea engelmannii), across gradients of elevation, aspect, soil type, and overstory subalpine fir mortality. In both species regeneration was strongly associated with local topography and appeared to not be adversely affected by subalpine fir overstory mortality. We found that subalpine fir seedling (height

Drought events occurring under warmer temperatures (i.e. “hotter droughts”) have resulted in widespread tree mortality across the globe, and may result in biome-level vegetation shifts to alternate vegetation types if there is a failure of trees to regenerate. We investigated how overstorey trees, understorey vegetation, and local climatic and edaphic conditions interact to influence tree regeneration, a key prerequisite for resilience, in a region that has experienced severe overstorey tree mortality due to hotter droughts and beetle infestations. We used detailed field observations from 142 sites that spanned a broad range of environmental conditions to evaluate the effects of climate and recent tree mortality on tree regeneration dynamics in the spatially extensive pinon (Pinus edulis)-juniper (Juniperus osteosperma, Juniperus monosperma) woodland vegetation type of the southwestern USA. We used a structural equation modelling framework to identify how tree mortality and local climatic and edaphic conditions affect pinon and juniper regeneration and electivity analyses to quantify the species-specific associations of tree juveniles with overstorey trees and understorey shrubs. Pinon regeneration appears to be strongly dependent upon advanced regeneration, (i.e. the survival of juvenile trees that established prior to the mortality event), the survival of adult seed-bearing trees (inferred from basal area of surviving trees) and the facilitative effects of overstorey trees for providing favourable microsites for seedling establishment. Model results suggest that local edaphoclimatic conditions directly affected pinon and juniper regeneration, such that stands with hotter, drier local climatic conditions and lower soil available water capacity had limited tree regeneration following large-scale dieback. Synthesis. We identify four indicators of resilience to hotter drought conditions: (1) abundant advance regeneration of tree seedlings; (2) sufficient canopy cover for survival of emergent seedlings and existing regeneration; (3) sufficient seed source from surviving trees with high reproductive output; (4) areas with cooler and wetter local climates and greater soil available water capacity. In the absence of these conditions, there is greater likelihood of woodlands transitioning to more xeric vegetation types following dieback.

Forests around the world are undergoing rapid changes due to changing climate and increasing physiological stress, but forest response to climate at the ecosystem scale can be highly variable due to the mixed responses of different trees across heterogeneous landscapes. To determine the response of ecosystems in the Rocky Mountains to climate stress, we investigated the response of subalpine fir (Abies lasiocarpa) and Engelmann spruce (Picea engelmannii), two widely distributed subalpine forest species of Rocky Mountains, to climate warming across a region characterized by gradients of elevation, aspect and soil type. We investigated the growth trend of individual trees through time, determined the climate variables most important for driving growth and quantified the interactions between climate and topography that influence long-term growth trends and potential ecological changes across the study region. Growth trends of these two species are similar through the first part of the century, but diverge during the last several decades. Since 1975, subalpine fir growth decreased through time, while Engelmann spruce growth increased. We find that aspect and warm summer temperatures are the most important factors determining growth in subalpine fir, and subalpine fir growth declines are greatest on east- and south-facing aspects. In contrast, Engelmann spruce growth is uniformly unresponsive to climate. In addition to highlighting the importance of species-level differences in growth response to climate, our results also identify interactions between climate and local physiography as controls on long-term growth trends and suggest that the local landscape physiography can mediate climate-related stress in forested ecosystems. This work advances our understanding of how forest stress is mitigated by landscape factors at the ecosystem scale, and how interactions of species, landscape and climate will control future ecosystem composition and forest growth dynamics.

The cost of plant reproduction or defense at the expense of other fitness traits is a central component of life history theory. Yet the three central resource allocation pathways of growth, reproduction, and defense have rarely been assessed simultaneously nor across individual to landscape scales. This information is critical towards identifying the physiological, environmental, and genetic mechanisms underpinning resource allocation. This study assessed trade-offs in resource allocation between tree growth, defense, and reproduction across scales among piñon pine (Pinusedulis), a widespread mast-seeding conifer of the southwestern USA. Time series (2004-2016) of tree growth (radial and primary shoot growth), defense (resin duct production; a key constitutive defense for this species), and cone production among individual trees from populations across a broad environmental gradient were used to investigate these trade-offs in resource allocation across three scales: individual, population, and landscape. We found evidence for a defense-reproduction trade-off among individuals whereby total resin duct area in annual xylem rings was lower during years of above average cone production. Despite variability in cone and resin duct production across trees within a population and across populations, there was no association between these fitness traits at either of those scales. There was no evidence of trade-offs between cone production and growth at any scales measured, whereas resin duct production and growth were positively related at all scales. Our study suggests that a strategic trade-off occurs whereby investment into defense is temporarily curtailed to favor reproduction, despite increased risk of exposure to natural enemies and the ability of piñon pine to simultaneously allocate carbon to growth and defense. Our study provides new insights into physiological expressions of growth, defense, and reproduction over time in this long-lived masting conifer and indicates the presence of trade-offs with direct importance for individual fitness and population dynamics under global change.

Climate warming is contributing to increases in wildfire activity throughout the western United States, leading to potentially long-lasting shifts in vegetation. The response of forest ecosystems to wildfire is thus a crucial indicator of future vegetation trajectories, and these responses are contingent upon factors such as seed availability, interannual climate variability, average climate, and other components of the physical environment. To better understand variation in resilience to wildfire across vulnerable dry forests, we surveyed conifer seedling densities in 15 recent (1988-2010) wildfires and characterized temporal variation in seed cone production and seedling establishment. We then predicted postfire seedling densities at a 30-m resolution within each fire perimeter using downscaled climate data, monthly water balance models, and maps of surviving forest cover. Widespread ponderosa pine (Pinus ponderosa) seed cone production occurred at least twice following each fire surveyed, and pulses of conifer seedling establishment coincided with years of above-average moisture availability. Ponderosa pine and Douglas-fir (Pseudotsuga menziesii) seedling densities were higher on more mesic sites and adjacent to surviving trees, though there were also important interspecific differences, likely attributable to drought and shade tolerance. We estimated that postfire seedling densities in 42% (for ponderosa pine) and 69% (for Douglas-fir) of the total burned area were below the lowest reported historical tree densities in these forests. Spatial models demonstrated that an absence of mature conifers (particularly in the interior of large, high-severity patches) limited seedling densities in many areas, but 30-yr average actual evapotranspiration and climatic water deficit limited densities on marginal sites. A better understanding of the limitations to postfire forest recovery will refine models of vegetation dynamics and will help to improve strategies of adaptation to a warming climate and shifting fire activity.

Background Trauma is a leading cause for major limb loss (MLL) during war. As societies transition into peace other factors become important. The voluntary sector plays a diminishing role in service delivery as countries transition towards peace. # Methods We undertook a retrospective review of 141 inpatient case notes at two hospitals in Northern Uganda to study the etiology of MLL. Focus group discussions, a literature search and key informant interviews were undertaken to ascertain patients' experience and the state of current services. # Results The most common indication for amputation was malignancy (36%), followed by gangrene and complications from diabetes. Trauma was the 5^th^ most common cause. The mean (standard deviation, SD) age of this cohort was 43 (22.2) years and the mean (SD) distance from their homes to the closest rehabilitation service unit was 91 (75) km. Less than 1% of patients were formally referred to rehabilitation services. Patients described experiences of stigma and marginalization impacting relationship and/or employability. Rehabilitation services were limited/unaffordable and inaccessible. Unpreparedness of government agencies in taking over rehabilitation services was evident. # Conclusions Non-communicable diseases account for the majority of MLL in this region now. These new cohorts of patients join an existing large pool of war-related amputees. Chronic dependence on the voluntary sector has rendered a state of unpreparedness amongst the local health providers.

A Correction to this paper has been published: https://doi.org/10.1038/s41467-021-22025-2

Forest and woodland ecosystems may be strongly affected by climate change influences on tree population processes such as seed production and seedling recruitment. Yet climate effects on seed production are generally poorly understood, particularly for trees that exhibit masting behavior (i.e. high synchronicity and high inter-annual variability in seed production). This is largely due to the limited amount of long-term datasets on seed production, which are necessary to characterize the highly variable reproductive outputs of masting species. The cone abscission scar method provides a promising approach to accurately determine historical (past 10–20 years) annual cone production, but the method has not been rigorously validated. Here we use a long-term dataset of cone abundance on individually monitored pinyon pine (Pinus edulis) trees to validate the cone abscission scar methodology. Tree cone production estimated using abscission scars was positively associated with observed mature cone and conelet abundances from 8 to 13 years previously (Spearman’s ρ = 0.52 and 0.66, respectively), the time period of our observed historical cone production data. Further, we show that between 4–5 branches per tree and 4–6 trees per site need to be sampled to minimize the variance in cone abundance estimates. Thus, only approximately 3–4 h are needed to obtain an estimate of historical annual cone production in a stand. Overall, we show that the cone abscission scar method provides a robust and time efficient approach to accurately determine historical annual cone production for P. edulis and likely other slow-growing conifer trees.

Tree mortality events driven by drought and warmer temperature, often amplified by pests and pathogens, are emerging as one of the predominant climate change impacts on plants. Understanding and predicting widespread tree mortality events in the future is vital as they affect ecosystem goods and services provided by forests and woodlands, including carbon storage needed to help offset warming. Additionally, if extensive enough, tree die-off events can influence not only local climate but also climate and vegetation elsewhere via climate teleconnections. Consequently, recent efforts have focused on improving predictions of tree mortality. The most commercially important genera of trees is Pinus, and the most studied species for tree mortality is the pinon pine, Pinus edulis. Numerous metrics have been developed in association with predicting mortality thresholds or variations in mortality for this species. In this Mini Review we compiled metrics associated with drought and warming related mortality that were developed for P. edulis or for which P. edulis was a key example species used in a calculation or prediction. We grouped these metrics into four categories: (i) those related to simple climate variables, (ii) those related to physiological responses, (iii) those that require multi-step calculations or modeling using climate, ecohydrological, and/or ecophysiological data, and (iv) modifiers of rates or sensitivities of mortality. We identified the spatial-temporal scale of each of these metrics. The metrics to predict mortality include empirical ones which often have implicit linkages to expected mechanisms, and more mechanistic ones related to physiological drivers. The metrics for P. edulis have similarities with those available for other species of Pinus. Expected future mortality events will provide an opportunity to observationally and experimentally test and compare these metrics related to tree mortality for P. edulis via near-term ecological forecasting. The metrics for P. edulis may also be useful as potential analogs for other genera. Improving predictions of tree mortality for this species and others will be increasingly important as an aid to move towards anticipatory management.